From the Departments of Medicine (Drs Gelber and Klag and Ms Mead) and Epidemiology (Drs Gelber and Klag), the Johns Hopkins Medical Institutions, Baltimore, Md; the Department of Medicine, Meharry Medical College, Nashville, Tenn (Dr J. Thomas and Ms D. Thomas); Mary Imogene Bassett Research Institute, Cooperstown, NY (Dr Pearson); and the Departments of Medicine, Epidemiology, and Preventive Medicine, University of Maryland School of Medicine, and the Geriatric Research Education and Clinical Center, Veterans Affairs Medical Center, Baltimore (Dr Hochberg). Dr Pearson is now with the Department of Community and Preventive Medicine, University of Rochester School of Medicine.

Background:Patients with gout are encountered frequently in clinical practice. Previous studies have suggested that hyperuricemia and gout may represent risk factors for coronary heart disease (CHD), the most common cause of death in American men.

Methods:Prospectively collected data from 2 longitudinal cohort studies of former medical students—371 black men in the Meharry Cohort Study and 1181 white men in the Johns Hopkins Precursors Study—were analyzed. The development of gout and of CHD was determined by physician self-report, and validated by using published criteria. The risk for CHD associated with gout was evaluated using Cox proportional hazards analysis.

Results:During a median follow-up of 30 years, there were 38 gout cases and 44 CHD events among the Meharry men, and 68 gout cases and 138 CHD events among the Hopkins men. Prior gout was not associated with an increased risk for incident CHD (relative risk=1.20; 95% confidence interval, 0.37-3.92) among the Meharry men or among the Hopkins men (relative risk=0.66; 95% confidence interval, 0.24-1.79). Multivariate analysis adjusted for known CHD risk factors did not alter these findings.

Conclusion:These results, in black and white male physicians, do not suggest a role in men for targeting gout identification in the primary prevention of CHD.Arch Intern Med. 1997;157:1436-1440